Capitol Correspondence - 09.23.19

Take Note: September 26 MACPAC Meeting to Discuss Medicaid Managed Care and HCBS

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The Medicaid and CHIP Payment and Access Commission (MACPAC) plays an important role in educating Congress on Medicaid policy. Its monthly meeting, which will be September 26, gives important insights on the Medicaid resources that help inform Congressional decision-making. Salient to the disability community, this meeting will include discussons on Medicaid managed care and home and community based services (HCBS).

As MACPAC shared in their meeting announcement:

“The September 2019 meeting of the Medicaid and CHIP Payment and Access Commission (MACPAC) will be held Thursday, September 26 from 9:30am–4:00pm and Friday, September 27 from 9:30am–11:45am at the Ronald Reagan Building and International Trade Center’s Horizon Ballroom.

The September meeting opens with a review of a draft of MACPAC’s January 2020 report to Congress on state oversight of institutions for mental diseases. This is the second of two studies assigned by the SUPPORT for Patients and Communities Act; MACPAC will issue its congressionally mandated review of state Medicaid utilization management policies on medication-assisted treatment in October.

The Commission then turns its attention to Medicaid managed care with a session on directed payments, a new option created in the 2016 managed care rule similar to fee-for-service supplemental payments. The final session of the morning addresses the implementation status of requirements that take effect in March 2022 for settings that provide home- and community-based services.

After lunch, the Commission reviews national and state-level data documenting declines in Medicaid and CHIP enrollment, the first enrollment declines since implementation of the Patient Protection and Affordable Care Act. The next session follows up on MACPAC’s June 2018 recommendations regarding the confidentiality of medical records of patients with substance use disorder, examining regulatory changes that the Substance Abuse and Mental Health Administration has proposed.

Then, after a brief break, MACPAC staff presents findings from the Commission’s analysis of the effects of drug formularies on utilization and spending in Medicaid and how this compares to other payers. The final session on Thursday addresses issues related to nursing facility payment.

MACPAC’s Friday agenda features two sessions on integration of care for people who are dually eligible for Medicaid and Medicare. The meeting opens with a panel on federal and state integration efforts, featuring Tim Engelhardt, director of the Medicare-Medicaid Coordination Office at the Centers for Medicare & Medicaid Services (CMS); Bea Rector, director of the Home and Community Services Division in Washington State; and Matt Wimmer, Medicaid director in Idaho. The meeting concludes with a discussion of the Commission’s potential future work in this area. 

Go to the MACPAC website for the full agenda and meeting information, along with MACPAC’s comments on CMS’s proposed repeal of state monitoring requirements regarding access to covered services and a new issue brief on Medicaid pharmacy and provider lock-in programs, which are aimed at preventing misuse of controlled substances. Follow us on Twitter @macpacgov to stay up to date on new publications, data updates, and meeting announcements.

Public comments: MACPAC will accept public comments during the morning and afternoon sessions, and on a continuing basis through our website. As always, we welcome your feedback and suggestions.

Directions: The Ronald Reagan building is easily accessible by rail. The Federal Triangle metro station (orange/blue lines) is on site. The Metro Center metro station (red line) is two blocks away. For additional information on the DC metro system, including bus routes, please go to The Ronald Reagan building has two entrances to its underground parking lot: on Pennsylvania Avenue NW and on 14th Street NW. Visit its website for current rates.

For more information about the meeting, contact Kathryn Ceja, MACPAC’s communications director.”